H. S. Micklen, who wrote the second article in the Fluoride Free NZ report, is one of the coauthors, together with Paul Connett, of the book The Case against Fluoridewhich anti-fluoride activists treat as gospel. His article was “peer-reviewed” by James Beck, the other co-author of the book.

In my comments I use the section headings used by H. S. Micklem.

Dental fluorosis

I think Micklen’s comments on dental fluorsis are quite muddled. He confuses the relevance of the different grades of dental fluorosis and unfairly attributes the more severe forms to community water fluoridation (CWF). Consequently he calculates a cost of dental treatment which is wrong.

Micklem is straw-clutching to take one reference used by the Royal Society Review out of context to imply that these studies are wrong because “subjects liked the appearance of a complete set of artificially white teeth.” He says “they did not like the whiteness associated with fluorosis.” But the authors actually say:

“The ranking of images of teeth with a fluorosis score of TF 1 may lead to the inference this sample of 11 to 13 year olds do not consider milder presentations of fluorosis to be aesthetically objectionable. The very white teeth represented an unnatural presentation that could only be achieved by cosmetic procedures. . . . This is consistent with previous work related to dental aesthetics [18,19] whereby teeth with mild forms of fluorosis (TF 1, TF2) were rated similarly.”

Micklem raises the bogey of the cost of veneers (up to $1750 per tooth) but this is just scaremongering as veneers would not be used for teeth with these mild grades of fluorosis.

Moderate and severe grades of dental fluorosis are common in areas where fluorosis is endemic, but relatively rare where CWF is used. Occurences in the later case, despite the low concentrations of fluoride in treated drinking water, will have other causes – high natural levels in well water, industrial pollution, excessive consumption of toothpaste, etc.

Treatment of moderate and severe cases of dental fluorosis using veneers may well be appropriate for a very few young people in countries like New Zealand and the US but it is misleading to attribute this to CWF. Interestingly, Micklem’s misattribution mirrors that of Ko and Thiessen (2014). They also assumed all moderate and severe dental fluorosis was caused by CWF thereby enabling them to declare no cost benefit to CWF because of the required dental treatments.

Micklem has simply continued the anti-fluoride propagandist tradition of confusing data for the relative amounts of different grades of dental fluorosis and attributing problems with the rare moderate and severe forms to the more common questionable and mild forms.

Neurotoxicity and IQ

In this section Micklem attempts to contrast the Choi et al (2012) metareview with the Broadbent et al (2014) study. He erroneously refers to both as being relevant to CWF and “the case that water fluoridation poses a development risk to human intelligence.”

Let’s make this clear. The Choi et al (2012) review did not include studies of CWF. The authors made clear that their results should not be seen as relevant to CWF. Most of the brief reports they reviewed studied areas of endemic fluorosis and Xiang (2014) (one of the authors of an included study) gives some idea of how this is manifested in a title slide to a recent talk.

The only study Micklem comments on that involved CWF was that of Broadbent at al (2014). Micklem describes this as “inconclusive” but does not say why. Do I detect some bias there?

Given the available studies I think the Royal Society review was justified in concluding “that on the available evidence there is no appreciable effect on cognition arising from CWF.”

Passing on to the question of the Choi et al (2012) metareview, which is not relevant to CWF. Micklen concedes that included studies were individually “not strong” but argues “the existence of so many studies almost all saying the same (important) thing” should be treated with attention and respect. I agree – but lets not allow that attention and respect to be blind. Let’s be aware of the limitations and attempt to understand what the results might mean.

The authors of that metareview have extended their work to making their own measurements in a pilot study (Choi et al., 2014). In this new paper they did not find a significant relationship between cognitive deficit measurements and drinking water fluoride. We need to accommodate this finding in our assessment of the metareview.

Choi et al (2014) did find a significant association of cognitive deficits with severe dental fluorosis. Perhaps we need to respect that finding and give it some attention. Rather than the assuming the mechanism of such cognitive deficits is the speculated but unproven neurotoxic activity of fluoride we should be open to other possible mechanisms (Perrott 2015)..

I have done so with my article Severe dental fluorosis the real cause of IQ deficits? and would welcome any feedback Micklem could give on this. I feel that the effects of a physical deformity like severe dental fluorosis on learning is a more realistic mechanism (for which there is a lot of published evidence) than some sort of vague chemical toxicity which has never been noted at these low concentrations.

Incidentally, Micklem attempts to discredit the Royal Society’s understanding of the Choi et al (2012) saying it suggested that the measured IQ reduction was “arguably negligible.” The Royal Society review actually said:

“Setting aside the methodological failings of these studies, Choi et al. determined that the standardised weighted mean difference in IQ scores between “exposed” and reference populations was only -0.45. The authors themselves note that this
difference is so small that it “may be within the measurement error of IQ testing”.[172]”

Choi et al., (2012) said:

“The estimated decrease in average IQ associated with fluoride exposure based on our analysis may seem small and may be within the measurement error of IQ testing.”

There has been some confusion because Choi et al., (2012) used a standardised weighted mean difference to accommodate the different IQ scales used in the studies they reviewed. But their warning about the small size of the calculated difference and its relationship to measurement errors in IQ testing is relevant.

The Royal Society Review did indeed make a mistake in the executive summary where it referred to a claimed IQ shift of “less than one IQ point” when it should have said “less than one standard deviation.” I discussed this in Did the Royal Society get it wrong about fluoridation? and noted that even Harvard University made the same mistake in its inital press release of the Choi et al (2012) work.

I think the Authors of the Royal Society Review should correct that mistake, as Harvard University did – but it does not change the fact there is no mistake in the review’s evaluation of the Choi et al (2012) paper.

Lead

In this section Micklem attempts to cast doubt on the Royal Society Review’s comments on the form of fluoride in drinking water and a possible role of fluoride in releasing lead from pipe fittings.

The hydrolysis of fluorosilicic acid when diluted during water treatment may not be completely understood (nothing ever is) but recent high quality research (Urbansky & Schock 2000; Urbansky 2002; Finney et al., 2006) has confirmed the review’s statement it is “effectively 100% dissociated to form fluoride ion under water treatment conditions.” Despite acknowledging the need for more and better research Urbansky (2002) concluded “all the rate data suggest that equilibrium should have been achieved by the time the water reaches the consumer’s tap if not by the time it leaves the waterworks plant.”

This debate only exists among anti-fluoride propagandists because of selective and motivated reliance on old and poor quality research, together with confirmation bias. For example, the report by Crosby (1969) that “evidence from specific-ion electrode and conductivity measurements at 25° confirms that sodium fluorosilicate, at the concentration normally present in public water supplies, is dissociated to at least 95%” is interpreted by Coplan et al., (2007) as “proof” the fluorosilicate is 5% unhydrolysed!

Micklem relies on then papers of Master et al., (2000), Copelan et al 2007 and Mass et al., (2007) to argue that fluoride treatment chemical enhances lead release from pipes. However, I think an objective assessment of these paper would conclude the authors argue determinedly for a preconceived hypothesis and that many of their arguments are irrelevant and faulty. This is not to dismiss their finding on lead levels in drinking water – but as Masters et al., (2000) themselves point out – “statistical association should not be confused with causation.”

Similarly, I suggest that Micklen’s reliance on Sawan et al., (2010) to support Copelan’s hypothesis amounts to special pleading as those workers used drinking water concentration of 100 mg/L of fluoride and 30 mg/L of lead.

Osteosarcoma

Micklem uses the old anti-fluoride activist trick of fixating on a cherry-picked paper which fits his agenda and downplaying or attempting to discredit papers which don’t. He concentrates on Bassin et al (2006), despite its description by its authors as “an explanatory study” requiring “further research” to “confirm or refute” its conclusions. That paper fits Micklem’s agenda because it found a statistically increased risk of osteosarcomas in male boys exposed to water fluoridated at 1.2 mg/L F.

In such a complex area, for a cancer with such a low incidence, a balanced overall consideration of research reports is necessary. All papers have their advantages and drawbacks so conclusions should be derived from proper consideration of the total research findings – as the Royal Society review appears to have done.

The Bassin (2006) findings have not been confirmed by any later work – despite a range of such studies (Kim et al., 2011; Comber et al., 2011; Levy and Leclerc 2012; Blakey et al., 2014). The Royal Society Review pointed out previous reviews had all concluded that “based on the best available evidence, fluoride could not be classified as carcinogenic in humans.” And that “more recent studies have not changed this conclusion.”

Micklem hasproduced nothing to counter that conclusion.

Cardiovascular and renal effects

Micklen attempts to use the paper, Martín-Pardillos et al., (2014), cited by the Royal Society Review, against the reviews conclusions. The review presents the paper this way:

“A number of studies indicate that fluoride may reduce aortic calcification in experimental animals and humans.[199] This preventive effect was recently confirmed by in vitro experiments, but in vivo findings from the same studies showed the opposite result – that phosphate-induced aortic calcification was accelerated following exposure of uremic rats to fluoride in water at around 1.5 mg/L.[200] The authors suggested that chronic kidney disease could be aggravated by relatively low concentrations of fluoride, which (in turn) accelerates vascular calcification. However, further studies are required to test this hypothesis.”

Martín-Pardillos et al., (2014) proceeded from the hypothesis that fluoride did not initiate calcification but because it is attracted to calcified deposits it may influence subsequent crystallisation of the calcified material.

Their in vitro results indicated a protective effect against calcification. While the opposite was observed with the 5/6 nephrectomised rats with induced calcification they still concluded:

“The direct inhibition of ectopic calcification could still occur in vivo when the renal function is correct, such as during aging or even the initial stages of diabetes, and this possibility deserves further research.”

This is relevant to healthy humans without chronic kidney disease (CKD).

The acceleration of induced vascular calcification with the 5/6 nephrectomised rats does raise the need for further studies, and monitoring the situation with humans suffering CKD. But let’s not forget the rat model was extreme. Rats had all of one kidney and 2/3 of the other kidney removed. They were also fed a phosphate enriched diet and the induced CKD was clearly indicated by urea and creatine blood concentration.

Of course these findings are relevant when considering ongoing research and monitory the situation of CKD human patients. As the authors say “the effects of fluoride on renal function and vascular health are more complicated than expected.”

Given that such patients are already monitory their diet and more advanced cases also probably regularly monitory blood indicators any possible effect of fluoride for individuals should be detected. It is likely that by the time any problem with fluoride in drinking water is indicated other problems will also have occurred and patients will be taking steps such as water filtering and careful dietary management to handle their situation.

In fact individually directed management of food and drinking water appears to be a sensible way of handling problems if they do occur with a few people.

Micklem’s “call for CKD sufferers to be warned to avoid tap water” is too extreme and alarmist. Already the advice is that persons with CKD should be notified of the potential risk of fluoride exposure and be kept up to date with new research. Any patients who are particularly worried can then take steps like using filtered water for their own peace of mind. This seems more appropriate than denying the rest of the population access to a simple, effective and safe (for them at least) social policy like CWF.

Conclusions

This completes my critique of the Fluoride Free NZ report.

The original Royal Society review,Health Effects of Water Fluoridation: a Review of the Scientific Evidence, was prepared in response to a request from councils for a summary of the current science on CWF. This is because over the last few years activists political groups, like Fluoride Free NZ (and its international associate Fluoride Action Network) have bombarded New Zealand councils with misinformation and distortion of the science in campaigns to prevent CWF or get it removed

Councils do not have the expertise to critical consider claims made by such activist groups and have adopted a policy of requesting central government take over their responsibilities on the issue. Until that happens, however, councils will continue to have such decisions forced upon them.

The Royal Society review provides a timely and authoritative source of information for councils. Understandably Fluoride Free NZ feels somewhat trumpted by the review. So it is understandable this activist groups, and the international associate will use their media influence to try to discredit it.

This report is an attempt to fool councils by pretending to be objective and international. Yet, as my articles in this series show, it is simply a put-up job. It is not objective – all the authors and “peer reviewers” are working for or associated with the Fluoride Action Network or its associates. The articles follow the typical cherry-picking and confirmation bias of such activist organisations.

Supplementary fluoride may not be of use for tooth health if the tooth pellicle contains proteolytic organisms capable of concentrating it from low concentration in saliva on the tooth surface. Seaweed is an organism which may concentrate iodine, in the same chemical group as fluorine from which fluoride comes.

I do believe we ought to take more cognisance of individual needs. Fluoride is suppose to help a certain portion of the population. I think researchers ought to indentify them. Because I feel it harm some such as top rugby players, if you read Kiwiblog.

I think the fluoride argument may be like keeping lead in all petrol because some cars need higher octane. Well not quite. More like keeping it in because some enthusiasts have ground down their heads to increase their compression ratios.

Once we can accept that premise then I can agree with supplementary fluoride and most of the research you are citing which is based on that.

The question is not what unqualified individuals and/or groups think should be done instead of fluoride, or how best they think dental decay prevention can be achieved. They haven’t the knowledge or expertise to make such assessments any more than would medical experts have to make assessments on the technical aspects of space exploration. It is a question of trusting the recommendations of those who are qualified, educated, and trained to make proper ones…or not to trust them. Antifluoridationists choose not to trust government, authority, or medical/dental experts. Fluoridation advocates choose to trust the consensus of peer-reviewed science, and the consensus opinion of respected science and healthcare.

On January 15, 2009, the NY Review of Books published Dr. Angell‘s devastating assessment of medical literature:

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”

“Six years ago, John Ioannidis, a professor of epidemiology at the University of Ioannina School of Medicine in Greece, found that nearly half of published articles in scientific journals contained findings that were false.”

“The peer review system is close to collapsing internationally under pressure from the expansion of tertiary education-associated science. Peer review has been the mainstay of quality assurance in science but it is a large but hidden cost on the science system. It is inherently flawed but, like democracy, no better system has been developed. However, the way peer review is conducted must change and the focus must be on finding and using systems that are transparent and ensure quality and integrity.” P8. Opening speech to the First Global Conference on Science Advice to Governments. 28 August 2014

…yeah right Kane… meanwhile, average life expectancy and world population health continues to increase and improve. Almost in entirety due to scientific endeavour allowing advances in medicine, nutrition, sanitation and engineering.

Poor old Kane. He is incapable of defending the sham report his organisation Fluoride Free NZ manufactured. He cannot find anything in my critiques to discredit. So he decided to attack science and its processes itself!

This is like the fool who sawed away at the branch he was sitting on.

1: He tries to discredit all science and clinical research seemingly oblivious to the fact his idol, Connett, and his organisation rely on citation of science and clinical research. Cherry-picked citations but nevertheless citation of the very thing he is condemning. Whoops, that branch is starting to crack.

2: He condemns peer review, trying to argue that peer review should be seen as a weakness not a strength. Yet his organisation makes a big thing of the “peer-review” process they used in their report. Comical “peer review”, but nevertheless they present that transparent trick as a strength.

Yes, Kane, I’ve seen the ridiculous claim that fluoridation is “faith based” before. The only thing I can figure is that antifluoridationists define “faith” as “peer-reviewed science”.

At any rate, it is always entertaining to see antifluoridationists attempt to discredit valid science, respected healthcare, healthcare professionals, and healthcare experts. Why do they do this? Because that is their only recourse. When the overwhelming consensus opinion of respected science and healthcare is in total disagreement with one’s dogmatic views, the only recourse is to either cease denial of the science, or seek to discredit all who disagree. As antifluoridationists will never cease their denial of the science, they are left with but one option…..absurd attempts to discredit respected science and healthcare. This is made even more comical by the fact that at the same time they seek to discredit science and healthcare, they put forward non peer-reviewed books and other such “literature”, unsubstantiated claims, misrepresented study results, out-of-context information, half-truths, and outright misinformation spoon-fed to them from activist websites and blogs, as the alternative which they recommend in place of the opinion of respected science and healthcare.

Thank you, Kane. If nothing else, you guys certainly do provide good entertainment on an otherwise boring day.

What a strange comment Trev. You surely noticed that I did not call this man names, or play the man rather than the ball. I commented on the papers. I repeat for you sake:

“Micklem relies on the papers of Master et al., (2000), Copelan et al 2007 and Mass et al., (2007) to argue that fluoride treatment chemical enhances lead release from pipes. However, I think an objective assessment of these paper would conclude the authors argue determinedly for a preconceived hypothesis and that many of their arguments are irrelevant and faulty. This is not to dismiss their finding on lead levels in drinking water – but as Masters et al., (2000) themselves point out – “statistical association should not be confused with causation.” “

I dealt with their attempta to distort the research to fit their wish that fluorosilicates do not decompose in water. I relied on evidence, not name-calling.

I realise you are not used to the idea of discussing evidence and making a crticial and intelligent appraisal of scientific papers. That you resort to name-calling becuase you are not capable of that sort of approach.

Coplan’s and Masters’ attempts to link fluoridated water to increased lead uptake, were refuted by Urbansky and Schock, and later by Macek, et al.

“Controlling for covariates, water fluoridation method was significant only in the models that included dwellings built before 1946 and dwellings of unknown age. Across stratum- specific models for dwellings of known age, neither hydrofluosilicic acid nor sodium silicofluoride were associated with higher geometric mean PbB concentrations or prevalence values. Given these findings, our analyses, though not definitive, do not support concerns that silicofluorides in community water systems cause higher PbB concentrations in children. Current evidence does not provide a basis for changing water fluoridation practices, which have a clear public health benefit.”

“Overall, we conclude that no credible evidence exists to show that water fluoridation has any quantitatable effects on the solubility, bioavailability, bio- accumulation, or reactivity of lead(0) or lead(I1) compounds. The governing factors are the concentrations of a number of other species, such as (bi)carbonate, hydroxide, or chloride, whose effects far exceed those of fluoride or fiuorosilicates under drinking water conditions.”

This study looks at use of toothpaste in Malaysia in people who have not kept their traditional ways.

I note the toothpaste chosen is a bit like one of the Colgate ones with calcium compound as the gentle abrasive. The toothpaste also contains fluoride.

“Modern” diet has increased caries and fluoridated toothpaste in Malaysia where fluoridation has been difficult has reduced it from the new level by 23% (though 40% at age 8 – the first teeth). That does not seem to be much different from what fluoridation does.

The study also looks at Strep mutans which is also considered by Dunedin dentist DB Ritchie, from where I got the mechanism you may be referring to as you say “The question is not what unqualified individuals and/or groups think should be done instead of fluoride, or how best they think dental decay prevention can be achieved. They haven’t the knowledge or expertise to make such assessments” if you read over to my Kiwiblog posts.

Ritchie believed non-abraded teeth are protected against sugar, also against the acid fruit season.

Steve, can you contribute more on countries, diets and types of tooth care/ toothpaste from the professional knowledge?

The question is not whether there are programs and/or healthcare techiques and habits which can improve oral health. Nor is it a question of whether all of these things have not been long since considered, and implemented where possible. It is a matter of there being such an overwhelming problem with untreated dental decay that we need all of these efforts in order to make inroads into it. Attempts to brainstorm about what could be done instead of fluoridation miss the point and are of very little value. What may seem like new information, or new ideas, to you and others, in regard to oral health will not be new to healthcare professionals, healthcare experts, and healthcare groups who are attuned to the problem and understand what is necessary to make any progress. These ideas and suggestions have all been long since known, considered, and implemented where possible, practical, and feasible.

Yes, we need educational programs. Yes we need effective preventive programs. Yes we need improved diets. Yes we need improved access to care. Yes we need productive research. Yes we need free and low cost dental programs…..yes, we need all of these things and more. However this does not preclude the need or value of water fluoridation, nor does fluoridation preclude the need for all of these other measures. We need all of them, not simply one or the other. Fluoridation is the most cost-effective means of providing dental decay prevention for entire populations. In its 69 year history, there have geen no proven adverse effects.

you are so concerned to improve dental health then why refuse to investigate ways other than fluoridation which is less than 50% effective?

In NZ the big “proof” that fluoridation does not hurt IQ is based on the Broadbent study which has 98 or so “controls” whose water may have been coming from old gold mining areas in Taieri and that is not noted. Furthermore it does not comment on whether its distributions are Gaussian.
Would you support me in a request for funding to explore this further? (I copy from my Kiwiblog discussion):

“‘Starting about 8 years after fluoridation kicked in in Birmingham about 1970 they have not had one football win over unfluoridated Manchester. Crusaders from unfluoridated Canterbury do very well. In the ITM Cup the top teams were unfluoridated Tasman and Taranaki. South Canterbury First Division stopped winning after fluoridation started in Timaru. This year Taieri won in Dunedin and West Taieri has only been fluoridated a few years. I’d appreciate some help with this.’

That clinches it for me.

For may years Petone was not fluoridated while Lower Hutt was on fluoride. The Petone rugby club is no longer the power it once was.

Why has the Ministry of Health steadfastly ignored the empirical data available so easily from the records of club rugby competitions?

Just when I was thinking the anti-fluoride commenters are just a bunch of nutcases they come up with this revelation…”

Let’s be clear, Sound hill – I have never suggested a mechanism for F to improve IQ. Let alone for people who “do not know how to care for their teeth.”

I have simply related the known negative effect of severe dental fluorosis on quality of life to possible IQ measurements. This is the psychological and social effect of a physical anomaly. Not the effect of pain.

As for your suggestion that top rugby players at “bright.” That has not been anything I have noticed – quite the opposite In fact.

Sorry meant to write: “And if fluorosis is a physical anomaly why isn’t missing teeth?
Ken, I am suggesting a corollary to your claim: that if a physical anomaly can affect quality of life and hence IQ, that preventing a physical anomaly may stop the IQ being reduced.

If fluoridation reduces tooth decay in some people who do not know how to look after their teeth, then it may reduce the average loss of IQ in the test group. Fewer school lessons lost for dentist visits included. The average for the test group may increase.

Of course missing teeth, and bad tooth decay, are physical anomalies which also affect quality of life, and probably learning etc., hence could be reflected in IQ.

Trouble is that while there is published research showing that moth tooth decay and dental fluorosis impact quality of life negatively I can’t find anything which directly relates this to IQ. Although it seems logical that physical anomalies will influence many factors that are also included in IQ assessment.

Part of the problem is that people like Choi, Grandjean, etc., have had a fixation on fluoride as a neurotoxicant – without any credible mechanism – and so far have seemed oblivious to other possible hypotheses.

“you are so concerned to improve dental health then why refuse to investigate ways other than fluoridation which is less than 50% effective?”

Obviously my previous post went right over your head.

First if all, I have not refused to investigate anything in regard to your thread here. That’s simply a fabrication on your part, typical of antifluoridationists who have no regard to truth and accuracy.

Second, once again, you inexplicably assume that the “investigation” you so desire, is not ongoing, and has not been ongoing for decades, if not centuries.

Third, you seem to believe that “less than 50 % effective” in regard to dental decay prevention, is some sort of a negative. Any prevention of this disorder is a huge plus. A 25-50% reduction is outstanding, meaning untold amount of reduction in lifetimes of extreme pain, debilitation, black discoloration and loss of teeth, development of serious medical conditions, and life-threatening infection.

The “proof” that fluoridation does not hurt IQ is based on Broadbent’s findings, sure, but primarily it is based on the total lack of any valid evidence, whatsoever, that it does hurt IQ. The IQ nonsense dates all the way back to the very beginnings of the initiative when John Birchers and other such ultra conservatives were paranoid about perceived government efforts to exert “mind control” over the populace. Antifluoridationists have tried their utmost over the past 7 decades to link fluoridated water to impeded brain function. The best they have been able to come up with in that entire time is the infamous “27 Chinese studies” they finally dug out of obscure Chinese journals, studies which were so ridiculously flawed that they serve as valid evidence of absolutely nothing.

I will not support you, or any other biased antifluoridationist in a “request for funding”. I would certainly support any such requests made by legitimate, qualified researchers who are capable of performing objective, quality research.

Regarding my last post it seems some of the variation between North and South Islands may be due to decile which is higher in the south. The partial correlation between island and literacy/numeracy goes down to about half, when decile is partialled out. But it is not spurious until the partialled correlation gets close to zero.

Comparing the correlation of literacy/numeracy with decile, and the same with island partialled out, gives a fairly similar figure (0.3308 vs 0.312.) That suggests island is not very causative.

So I need to look for an easy table of what places are fluoridated, not just take SI as not and NI as like I did
Any offers?

So if I do more about fluoridation it will probably include geographical latitude as a variable under test, as well as the introduction of sunscreens, and maybe the 1960s introduction of frequent washing of the whole body with soap which may remove sterols and cause the vitamin D precursor irradiated sterols to migrate to the surface too much.

should beer be fluoridated to protect drinkers? Some people get a large proportion of their water from beer. (And sorry I think I was more like age 24.)

You are happy with the proportion of DMFT fluoridation reduces. How many more percent would it take to make you happier enough
to put proportional effort into furthering it?

And do you think the NZ 245-T matter is nonsense? Do you think that number of people do not matter?

I feel we should always be trying to fine tune our ways. Now people supplementing calcium can add as well as vitamin D, vitamin K2 to encourage the calcium to go to the bones rather than to the artery walls.

I feel that the population based approach for fluoridation could be checked for affect on individuals who may be escaping through the current statistics. It might be the presence or lack of other nutrients such as molybdenum. Or it might be genetic or epigenetic, as well as other matters I have talked of recently.

One of my dentists was interested in individuals. He could use anaesthetics with less or no adrenalin. But he wasn’t right into testing for individual allergy to dental materials. I have talked quite a lot about it on the google group sci.med.dentistry “Brian Sandle”, including electrical potentials between teeth from different amalgams, but maybe the worse problem of shrinking composites which most me several teeth. (I had been wanting to spit those fillings out since they were placed and am wondering what stress they put on my body in the few years they were there.)

More as regards conspiracy I have to say unless you are prepared to put proportional effort into to furthering improvements it has to look like you are forced to accept fluoridation and it is not too bad since it does not reduce dentists’ work too much. I’ll leave that comment in but I suppose it is at the risk you will concentrate on it and ignore the rest.

You assume that fluoridation is the only preventive measure promoted by the healthcare community. It is not. There are constant and consistent efforts to develop and support initiatives to improve dental health, to improve access to dental care, to provide education and educational programs, and to fund, support, and perform research into materials, substances, and techniques which will prevent dental disease.

NZ-245T is irrelevant to water fluoridation.

Water fluoridation does not eliminate, in any manner, “trying to fine tune our ways”.

Water fluoridation is a public health initiative. Public health initiatives are assessed by their impact on entire populations, not by individual mechanisms. Countless peer-reviewed studies clearly demonstrate the effectiveness of fluoridation in the reduction of dental decay in entire populations.

@Steve: “Public health initiatives are assessed by their impact on entire populations, not by individual mechanisms” Sometimes true. For example sometimes it is admitted that a drug like penicillin or a vaccine administered to reduce the incidence of disease in a population may have individual effects. Sometimes it isn’t and people are not advised to be watchful.

The 245-T matter appears to be a financial/liability matter conflicting with public health.

Asbestos is another public health matter. In that case why do soem people cope better than others? Though there may not be the range there could be as with cigarettes. And depression from withdrawal needs to be taken into account there.

It may be hard to find a public health matter where financial interests are not involved. The TPPA is set to give corporates the right to sue in an international tribunal, governments who want to protect their water purity from industry.

In dentistry there has been the whole amalgam/composite battle, with composite sellers covering up such matters as bis-GMA or related toxins in their products.

Sound hill, financial interests are certainly behind the anti-fluoride movement. In NZ the High Court actions are financed by the NZ Health trust, a political lobby group for the “natural” health industry – big business and big money involved.

Paul Connett’s crowd is financed by similar interests with the quack Mercola involved financially.

He is making a fortune out of selling “natural” health products and does finance Connett’s crowd. The anti-fluoride propagandists are an integral part of the “natural” health movement and Connett’s regular misinformation missives all go through the “natural” health propaganda network – including Mercola’s. Mercola is also organisationally linked to Connett’s group.

So you claim Mercola is indirectly making money by being associated with the the anti-fluoridation people?

Or is it that desperate people in search of health may be sticking together a bit when the public health system is only doing a 40% job?

There is the ability to comment on his board. more than so on many public health initiatives. For example I have been warned on the ANZFSA FB group, and never warned by Mercola for talking against amalgam removal and composite replacement.

Sound hill, you made the claim “It may be hard to find a public health matter where financial interests are not involved.”

I have shown to you how corporate interests are heavily involved in the “natural” health movement and the anti-fluoridation propaganda. Of course they are profiting from their quackery and dissemination of mis formation and distortions.

And they are taking advantage of hypochondriacs and “desperate people” who will believe anything. This quackery is a disgustingly dishonest money making business.

This seems to upset you as you are one of Mercola’s victims, it seems.

I’ve never bought anything from Mercola. I asked my dentist for a fluoridated toothpaste without strong sweeteners in it. She suggested a child’s toothpaste. But she also said my problem is wear of the teeth. But thanks for the pointer to xylitol-sweetened toothpaste.

Yes the natural health industry are not immune to scams. Sometimes they are even supported by the Advertising Standards Authority who allowed a long TV ad claiming bee pollen has more calcium than milk. Whoever heard of anyone eating even 100ml of pollen and the words weight by weight where hard to find.

@Steve “Respected manufacturers of dental materials do not “cover up” the contents of their products.” Have manufacturers made it obvious to your patients that there are dimethacrylates in composites which may elute? And have you seen the hands of some of dental technicians who work with methacrylates, let alone dimethacrylates?

@Steve: “7. There is no “amalgam/composite battle” in dentistry.”
In my impression the debate over amalgam replacement is fed by shills from the composite industry. OK, as you have said several times, that has nothing to do with fluoridation, so why make the statement?

@Ken “Infant formula
There has been some legitimate concern about the systemic intake of fluoride by infants
and young children, and in particular, the level of fluoride present in infant formulas. The
average intake by infants exclusively fed formula made up with fluoride-free water was
estimated as 0.056 mg/day, or approximately 0.01 mg fluoride per kilogram body weight
per day (mg/kg/day), which is at the lower end of the recommended range (see below –
section 2.4.1). This is because infant formulas currently available in New Zealand are low in
fluoride, but if they are reconstituted with water fluoridated at 0.7-1 mg/L, they can provide
infants with fluoride at levels approaching or exceeding the recommended upper level for
daily intake (particularly at the upper end of the fluoridation range, and for exclusively
formula-fed infants drinking the maximum amount).[39]
26
The Australia New Zealand Food Standards Code specifies that powdered or concentrated
infant formulas containing >17μg of fluoride per 100 kilojoules (prior to reconstitution), or
‘ready to drink’ formulas containing >0.15mg fluoride per 100mL must indicate on the label
that consumption of the formula may cause dental fluorosis.[42]”

So you really need differing formulations for fluoridated from non-fluoridated areas.

“Infants 0-6 months of age who are exclusively fed formula reconstituted with fluoridated water will have intakes at or exceeding the upper end of the recommended range (UL; 0.7 mg/day). The higher intakes may help strengthen the developing teeth against future decay, but are also associated with a slightly increased risk of very mild or mild dental fluorosis. This risk is considered to be very low, and recommendations from several authoritative groups support the safety of reconstituting infant formula with fluoridated water. “

Because of the low risk of dental fluorosis health authorities support use of fluoridated water. Usually they do make a “peace of mind” recommendation for parents who are concerned to occasionally use unfluoridated water.

It would be silly to recommend different formula for fluoridated and unfluoridated areas. Especially as he F content of formula is,my regulation, uniformly low.

Either/Or. The optimal level of fluoride is that level at which maximum dental decay prevention will occur with no adverse effects. Optimum level fluoridation is water fluoridated with optimal level fluoride.

The only “caution with infant bottle feeding” is in regard to mild to very mild dental fluorosis. Due to the existing fluoride content of powdered infant formula, the use of fluoridated water to reconstitute it risks mild to very mild dental fluorosis in developing teeth of the infants. Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function or health of teeth. As Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many consider this effect to not even be undesirable, much less adverse.

For those parents who are concerned even with mild dental fluorosis, in spite of the decay preventive benefit, the ADA and the CDC have suggested they use non-fluoridated bottled water to reconstitute powdered formula, or simply use premixed formula, most, if not all, of which is made with low fluoride content water.

“In my impression the debate over amalgam replacement is fed by shills from the composite industry. OK, as you have said several times, that has nothing to do with fluoridation, so why make the statement?”

There is no “debate over amalgam replacement”. You brought this up, not I.

I don’t know about the newer digital xrays but the older ones gave a significant dose that you would not want them every 3 months for which you could have a physical palpation by a trained nurse. Waiting the 2 year mammography wait is a bit long for cancer as aggressive cancer may grow large in such time. Mammography may detect smaller cancers, which is the big selling point, but you would detect more with 3-monthly physical exams. And the little lumps found by mammography and followed up by biopsies are often not cancers.

Maybe fluoridated Dunedin has the dental school which could be a reason for the small number of patients per dentist. But compare fluoridated Palmerston North, and not far away non-fluoridated Wanganui. Wanganui has half the dentists per population as does fluoridated Palmerston North.

Be good to keep wondering how many years of fluoridation then I might do a correlation.

Dr Slott. your remark about me is a reflection of your obsession with fluoridation. For your info I have a flue injection annually, a family member has just completed a course of rad therapy for cancer, I take prescription medicine for blood pressure, I admire the science that enabled my blocked artery to be stented. I do not subscribe to conspiracy theories but I do have concerns over the continual blind adherence to advancing a treatment of caries with drinking water that has magically been turned into a medicinal compound.
I have yet to see any primary research from anywhere which confirms that adding HFA to my drinking water is good for my teeth and has absolutely no ill effects on any other part of my body and I mean research, not simply confirmation reviews of studies that have confirmed previous confirmation studies.
I note that learned ‘experts’ like J Broadbent are still selectively citing elements of the 2000 York report as proof positive that fluoridation is safe, beneficial and cost effective when the executive summary raises serious questions around the quality, validity and age of the studies reviewed.
You continually accuse people who raise concerns about fluoridation of lying, cheating, obfuscating and being sub-human but then expect respect and praise when pro-fluoridation advocates engage in exactly that sort of behaviour in support of their obsession. Get real!

Ken – re Dr Gotzsche – He is highly regarded in Denmark and committed to seeking the truth He has published a book which is the personal story of how he was asked by the Danish Board of Health to “take a look at” breast cancer mammographic screening because of a pending vote. The book details a 10 year odyssey and battle to expose the truth and lies and harms of routine mammographic screening. Peter Gotzsche discovered that no one knew, or at least no one was discussing, the harms of screening, and further, that the benefits were vastly overrated.
The issues he outlines can be applied to many areas of human activity including fluoridation. Look him up Ken I hardly think he is crank, a nutter or a conspiracy theorist. Like a lot of people concerned at some of the devious practices that pass for research and science he speaks out about it and yes, he has been denigrated and ostracized for telling it like it is.
By the way, have you read ‘The Fluoride Deception’ by Christopher Bryson?

OK Trev, this is much better than a drive by troll link to a book cover without any explanation.

But the question why? What has this to do with the post your commented under? Why the reference to nutters? (You seem to have a fixation with that word which is meaningless is in proper discussion.)

I am well aware of the controversies over mass screening (more so for prostate than breast). It’s just not true to claim this issue is not discussed.

As for the Fluoride Deception – I have often commented on it here and elsewhere – read it ages ago. It is relevant to the problems of industrial pollution and that history. It is not relevant to community water fluoridation or issue related to effects at optimum concentrations.

I get the impression that many people who refer to it, and use it in drive by troll comments, actually have not read it.

Trevor
Your paranoid conspiracy theories are a “reflection of [my] obsession with fluoridation”? The logic of that claim escapes me.

The medical histories of you and your family, I’m sure, are of importance to you, but are entirely irrelevant to water fluoridation.

Please cite exactly where I have accused “people who raise concerns about fluoridation of lying, cheating, obfuscating, and being sub-human”. This is a prime example of the total disregard of antifluoridationists with truth and accuracy. The only times I have accused anyone of “lying” is when there is blatant confirmation that they have indeed done so, such as exactly what you have done in this comment. “Obfuscating” is a term which has been used by antifluoridationists against me, not the other way around. I may have replied that they were the ones “obfuscating”, not I, but only in response. To my knowledge I have accused no one of “cheating” in regard to fluoridation, and I have never referred to anyone as being “sub-human.

I have repeatedly posted peer-reviewed scientific studies which clearly demonstrate the effectiveness of fluoridation. That you reject them is entirely your prerogative but has no bearing on their validity.

If you want respect, Trevor, then begin earning it. Stick to the truth, properly educate yourself on this issue, and drop the irrelevant conspiracy nonsense.